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Psychological Determinants of Erectile Dysfunction: Testing a Cognitive–Emotional Model
Abstract
INTRODUCTION: Recent studies have shown the impact of sexual dysfunctional beliefs, negative cognitive schemas, negative automatic thoughts, and depressed affect on male erectile dysfunction. Despite this fact, there are only few conceptual models that try to integrate these findings, and more importantly, there is a lack of studies that test the validity of those conceptual models. AIM: The aim of the present article was to test a cognitive-emotional model for erectile dysfunction. Taking previous research findings into account, we developed a cognitive-emotional model for erectile disorder (ED) and used path analysis to test it. METHODS: A total of 352 men (303 participants from the general population and 49 participants with a DSM-IV diagnosis of sexual dysfunction) answered a set of questionnaires assessing cognitive and emotional variables. MAIN OUTCOME MEASURES: Erectile Function measured by the EF subscale of the International Index of Erectile Function, cognitive schemas measured by the Questionnaire of Cognitive Schema Activation in Sexual Context, sexual beliefs measured by the Sexual Dysfunctional Beliefs Questionnaire, thoughts and emotions measured by the Sexual Modes Questionnaire. RESULTS: The effects of the main proposed direct predictors explained 55% of the erectile function variance (R = 0.74). Most remaining direct effects proposed in the model were also statistically significant. The analysis of the absolute residuals showed that most of the implied correlations were close to the observed zero order correlations, indicated the adjustment of the model to the observed data. CONCLUSIONS: These findings support the role played by cognitive and emotional factors on the predisposition and maintenance of male erectile dysfunction and suggest important implications for assessment and treatment of ED.
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“In addition to cognitive distraction, negative automatic thoughts (eg, I am a failure, I need to perform, my erection is not firm enough) and macho-beliefs that involve unrealistic, unattainable expectations of male sexual performance (eg, penile erection is essential for a woman's sexual satisfaction, failing to get an erection may result in the woman leaving me) may predispose men to get trapped”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [23]
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Metadata
- Authors
- Nobre, P. J.
- Affiliations
- University of Trás-os-Montes and Alto Douro (PT)
- Corresponding author
- Nobre, Pedro J.
- ORCID
- Nobre, Pedro J.
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-04-01
- Volume
- 7
- Issue
- 4_Part_1
- Pages
- 1429-1437
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- OpenAlex
- W1926346160
- Cited by
- 121
- References
- 31
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 9 · 2023: 10 · 2022: 7 · 2021: 9 · 2020: 8 · 2019: 7 · 2018: 8 · 2017: 12 · 2016: 9 · 2015: 10 · 2014: 6 · 2013: 3 · 2012: 1
- FWCI
- 3.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- The Journal of Sexual Medicine (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- erectile dysfunction, cognitive schemas, negative automatic thoughts, depressive affect, sexual dysfunction, erectile function, sexual beliefs, men
- MeSH terms
- Adolescent, Adult, Aged, Attitude, Cognition, Emotions, Humans, Erectile Dysfunction, Male, Middle Aged, Penile Erection, Surveys and Questionnaires, Cognitive Behavioral Therapy, Sexual Dysfunctions, Psychological, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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